 |
|
Congenital Nonprogressive Hemangioma
A Distinct Clinicopathologic Entity Unlike Infantile Hemangioma
Paula E. North, MD, PhD;
Milton Waner, MD;
Charles A. James, MD;
Adam Mizeracki, BS;
Ilona J. Frieden, MD;
Martin C. Mihm, Jr, MD
Arch Dermatol. 2001;137:1607-1620.
Background Infantile hemangiomas are common tumors, distinctive for their perinatal presentation, rapid growth during the first year of life, and subsequent involution—and for their expression of a unique immunophenotype shared by placental microvessels. Occasional "hemangiomas" differ from the classic form in presenting fully formed at birth, then following a static or rapidly involuting course. These congenitally fully developed lesions have generally been assumed to be clinical variants of more typical, postnatally developing hemangiomas. This assumption has not been tested by rigorous histologic and immunophenotypic comparisons.
Objective To compare the histologic and immunohistochemical features of congenital nonprogressive hemangiomas with those of typical, postnatally proliferating, hemangiomas.
Design All cellular vascular tumors resected from infants younger than 4 months at Arkansas Children's Hospital, Little Rock, over the past 20 years (43 lesions from 36 patients) were first characterized histologically and immunohistochemically, then clinically by chart review.
Setting A university-affiliated pediatric hospital.
Main Outcome Measures Histologic appearance, immunoreactivity for the infantile hemangioma–associated antigens GLUT1 and LeY, and clinical behavior.
Results Congenital nonprogressive hemangiomas differed from postnatally proliferating infantile hemangiomas in histologic appearance and immunohistochemical profile. Distinguishing pathologic features of these tumors were lobules of capillaries set within densely fibrotic stroma containing hemosiderin deposits; focal lobular thrombosis and sclerosis; frequent association with multiple thin-walled vessels; absence of "intermingling" of the neovasculature with normal tissue elements; and lack of immunoreactivity for GLUT1 and LeY.
Conclusion Congenital nonprogressive hemangiomas are histologically and immunophenotypically distinct from classically presenting hemangiomas of infancy, unlikely to be related to the latter in pathogenesis.
From the Departments of Pathology (Dr North and Mr Mizeracki), Head and Neck Surgery and Otolaryngology (Dr Waner and Mr Mizeracki), and Radiology (Dr James), the University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock; the Departments of Pediatrics and Dermatology, University of California at San Francisco Medical Center, San Francisco (Dr Frieden); and the Department of Pathology, Harvard University Medical School and Massachusetts General Hospital, Boston, Mass (Dr Mihm).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Relational Databases for Rare Disease Study: Application to Vascular Anomalies
Perkins and Coltrera
Arch Otolaryngol Head Neck Surg 2008;134:62-66.
ABSTRACT
| FULL TEXT
Hemangiomas of Infancy: Clinical and Biological Characteristics
Smolinski and Yan
CLIN PEDIATR 2005;44:747-766.
ABSTRACT
Giant Rapidly Involuting Congenital Hemangioma of the Face: 15-Year Follow-up
Lopez-Gutierrez et al.
Arch Facial Plast Surg 2005;7:316-318.
ABSTRACT
| FULL TEXT
The Nonrandom Distribution of Facial Hemangiomas
Waner et al.
Arch Dermatol 2003;139:869-875.
ABSTRACT
| FULL TEXT
|
